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中华肾病研究电子杂志 ›› 2022, Vol. 11 ›› Issue (04) : 207 -211. doi: 10.3877/cma.j.issn.2095-3216.2022.04.005

论著

慢性肾脏病合并肺结核患者抗结核治疗转归相关因素分析
俞珊1, 李志明1, 段浩凯1, 杨荔慧1, 刘银萍2, 王涛1,()   
  1. 1. 100091 北京,解放军总医院第八医学中心结核病医学部结核病科四病区
    2. 100091 北京,解放军总医院第八医学中心结核病医学部研究室
  • 收稿日期:2022-03-07 出版日期:2022-08-28
  • 通信作者: 王涛

Analysis of related factors for the outcome of anti-tuberculosis treatment in CKD patients complicated with pulmonary tuberculosis

Shan Yu1, Zhiming Li1, Haokai Duan1, Lihui Yang1, Yinping Liu2, Tao Wang1,()   

  1. 1. Fourth Ward of Department of Tuberculosis, Senior Department of Tuberculosis; Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China
    2. Laboratory of Senior Department of Tuberculosis; Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China
  • Received:2022-03-07 Published:2022-08-28
  • Corresponding author: Tao Wang
引用本文:

俞珊, 李志明, 段浩凯, 杨荔慧, 刘银萍, 王涛. 慢性肾脏病合并肺结核患者抗结核治疗转归相关因素分析[J/OL]. 中华肾病研究电子杂志, 2022, 11(04): 207-211.

Shan Yu, Zhiming Li, Haokai Duan, Lihui Yang, Yinping Liu, Tao Wang. Analysis of related factors for the outcome of anti-tuberculosis treatment in CKD patients complicated with pulmonary tuberculosis[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2022, 11(04): 207-211.

目的

回顾性分析慢性肾脏病(CKD)合并肺结核患者的抗结核治疗转归相关因素。

方法

纳入2017年1月至2021年6月我院收治的资料完整、CKD合并肺结核病患者84例,分析其一般情况、病史特点、化验指标、外周血淋巴细胞亚群、药物不良反应发生率,以及抗结核治疗转归相关因素。

结果

84例患者中男性占76.54%,中位年龄53.5(41.25,63.00)岁。治疗有效组和无效组患者在性别、年龄、CKD分期、治疗史、吸烟史、糖尿病病史、高血压病史、γ干扰素(interferon-γ,IFN-γ)释放试验、结核抗体、白蛋白、肾功能、尿比重、尿蛋白、尿红细胞等方面比较无统计学差异。治疗无效组血红蛋白、总淋巴细胞计数、CD8+T细胞计数均低于有效组(P<0.05)。Logistic回归分析显示总淋巴细胞计数与治疗转归相关(P<0.05)。

结论

CKD合并肺结核治疗无效组患者贫血重、CD8+T细胞计数及总淋巴细胞计数减少。总淋巴细胞计数减少与治疗转归差相关。

Objective

To retrospectively analyze the factors related to the outcome of anti-tuberculosis treatment in patients with chronic kidney disease (CKD) complicated with pulmonary tuberculosis.

Methods

From January 2017 to June 2021, 84 patients with CKD complicated with pulmonary tuberculosis who were admitted to our hospital with complete data were included. The general conditions, medical history characteristics, laboratory indicators, peripheral blood lymphocyte subsets, incidence of adverse drug reactions, and factors related to the outcome of anti-tuberculosis treatment were analyzed.

Results

Among the 84 patients, 76.54% were male, and the median age was 53.5 (41.25, 63.00) years. There were no statistical differences between the treatment-effective group and the treatment-ineffective group in the following aspects, including gender, age, stage of CKD, treatment history, smoking history, diabetes history, hypertension history, interferon-gamma release assay, tuberculosis antibody, albumin, renal function, urine specific gravity, urine protein, and urine red blood cells, etc. The hemoglobin, counts of total lymphocytes and CD8+ T cells in the treatment-ineffective group were lower than those in the treatment-effective group (P<0.05). Logistic regression analysis showed that the lymphocyte count was associated with the treatment outcome (P<0.05).

Conclusion

The treatment-ineffective group showed severe anemia, lower counts of CD8+ T cells and total lymphocytes. The lower count of total lymphocytes was associated with the poorer treatment outcome.

表1 抗结核治疗有效组和无效组CKD患者一般情况比较
表2 两组患者实验室检查结果比较
表3 两组患者T细胞亚群比较
表4 Logistic回归分析结果
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